As caregivers, our #1 role is protection—protecting our children, our elderly parents, our patients, even our staff and colleagues. Notice how I didn’t mention protecting ourselves? This is off-radar for most caregivers until they have no choice, until their own survival is threatened. The same is true for physicians. Self-protection is not a thought that commonly enters our minds.
COVID-19 places physician caregivers in the impossible position of sacrificing their protection of one group for another. We are left in a fail-fail scenario.
And our failure to protect those who are the most vulnerable, our most beloved, leads to further trauma to the physician caregiver. Simply, this pandemic is traumatizing our trauma teams.
I was one month late writing this post. Why? Because I was on call 24-7, twelve days straight, trying to protect my very elderly parents—one immunosuppressed and hospitalized in isolation, the other the most terrified and traumatized she has ever been in her almost century-long life. It took seven days before I realized I was terrified and traumatized too. Other than inquiring about the well-being of every single healthcare professional involved in my parent’s care, I could not begin to wrap my head around what my colleagues were experiencing--their suffering, their overwhelming feelings of guilt, of horrific failure (both as physicians and as parents/caregivers), their fears, their hidden traumas. Now I realize this delayed awareness is also common for them --as they continue to work in the trenches 24-7, day after day, week after week, soon month after month.
None us of are allowed to come up for air, literally, in the case of this virus. Instead, we actually put our lives in danger every time we take a deep breath.
But we continue to do what we do best. Emergency-mode. Urgent-mode. Trauma-mode. We delay assessing ourselves for lack of sleep, lack of food, lack of bathroom breaks--for multiple hours, if not days or weeks later. And because we are experts at functioning in trauma-mode, we become blinded to its potentially deadly effects on us.
If I could change this entire post to an enormous red-blinking WARNING sign, I would.
We are not prepared for the PTSD that will follow in the weeks, months, or even years ahead. It will be delayed. It may show up in unexpected or indirect ways, because, we physicians have perfected hiding our own trauma. So well, in fact, that we hide it from ourselves. All physicians and healthcare staff are at risk. Those who are caretakers are at even higher risk.
What do we do about this?
The first step is to bring this into our awareness—both as individuals and to our society as a whole.
The second step is to take action. Actions can be those of prevention, support, or healing. We need all.
Some of our media outlets are bringing this awareness of personal trauma into the public eye. Many courageous souls in the medical field are doing the same. I am heartened, for example, that our Surgeon General in California, Dr. Nadine Burke Harris, an expert on toxic stress, has been given a voice during this pandemic to address exactly this. May she be one of many voices.
Groups are coming together to offer resources—colleagues supporting colleagues--psychiatrists, physician coaches, and more.
I encourage each one of us to become aware of our own needs, our own trauma—both new and newly reactivated--before it’s too late.
I also encourage everyone who can play a supportive or healing role to do so.
Together, we can and will get through this. And if creating effective systems to address, prevent, and heal trauma and toxic stress is one of the positive by-products of this horrific pandemic, all the better.
This post originally appeared on KevinMD.com on 4/19/2020